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Mortality patterns in Dutch diabetes outpatients.

Jessica C G Bak1,2, Silvia A G de Vries1,2, Erik H Serné1

  • 1Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands.

Diabetes, Obesity & Metabolism
|July 29, 2024
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Summary

Mortality rates are high for Dutch outpatients with diabetes, particularly type 2. Smoking and renal failure significantly increase mortality risk, highlighting the need for early intervention.

Keywords:
database researchdiabetes complicationstype 1 diabetestype 2 diabetes

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Area of Science:

  • Endocrinology
  • Public Health
  • Epidemiology

Background:

  • Diabetes mellitus is a leading cause of mortality globally.
  • Outpatient populations with diabetes experience higher complication rates compared to general practice.
  • Limited research exists on specific mortality patterns within diabetes outpatient settings.

Purpose of the Study:

  • To investigate mortality rates, causes of death, and associated predictors in Dutch outpatients with diabetes.
  • To analyze mortality trends in relation to specific diabetes types (Type 1 and Type 2).
  • To identify risk factors contributing to mortality in this population.

Main Methods:

  • A cohort study utilizing data from the Dutch Paediatric and Adult Registry of Diabetes (DPARD) from 2016-2020.
  • Linking DPARD data with Statistics Netherlands (CBS) for comprehensive mortality, ethnicity, and education information.
  • Employing Cox proportional hazard regression to estimate all-cause and cardiovascular mortality rates.

Main Results:

  • High mortality rates observed: 67.7 per 10,000 person-years for adult type 1 diabetes and 324.2 for type 2 diabetes.
  • Malignancy was the primary cause of non-cardiovascular death.
  • Mortality rates peaked during pandemic years (2018 influenza, 2020 COVID-19).
  • Key predictors of all-cause mortality included age, smoking, and impaired renal function (eGFR <60 ml/min).
  • Additional risk factors for type 2 diabetes mortality included male sex, low BMI, short diabetes duration, and hypertension.

Conclusions:

  • Dutch outpatients with diabetes exhibit elevated mortality.
  • Smoking and renal failure are significant mortality predictors in both diabetes types.
  • Early detection and management of identified risk factors are crucial for improving clinical outcomes in diabetes care.